Understanding illness trajectories to improve the quality of care for people with stage 5 chronic kidney disease on Kidney Replacement Therapy
Eligibility: UK/International (including EU) graduates with the required entry requirements
Funding details: Bursary plus tuition fees (UK/International (including EU at international rates from Sept 21)
Duration: Full-Time – between three and three and a half years fixed term
Application deadline: 27 May 2023
Interview dates: Will be confirmed to shortlisted candidates
Start date: September 2023
To find out more about the project, please contact Dr Emma Murphy.
Introduction
Coventry University is inviting applications from suitably-qualified graduates for a fully-funded PhD studentship.
The annual acceptance rate for kidney replacement therapy (KRT) in the United Kingdom is rising steadily1 with a disproportionate number of older, frail patients with other co-morbid conditions1. Despite the initiation of KRT, older patients can expect a continued decline in functional status, increasing frailty and loss of independence2-4. In addition, older patients receiving dialysis, about 1 in 4 older patients receiving KRT will not live more than 1 year from starting dialysis, and this falls to about 1 in 3 who will not live more than 2 years5. Dialysis patients often have complex palliative and supportive care needs6, yet these needs have not always had sufficient attention alongside technological interventions in nephrology. This project therefore seeks to understand the illness trajectories of patients managed with KRT and to explore their experience of illness to identify ways in ways in which the quality of care of these patients may be improved.
Project details
Detailed evidence about palliative needs and interventions among people on KRT is limited, however, we do know that symptoms are of a major concern to patients and symptom burden in end-stage kidney disease (ESKD) is high7. Nevertheless, there has been little research on symptoms and other concerns of patients on KRT over time and towards death. This project, therefore, aims to address this lack of evidence, designed with the primary aim of describing symptoms and other concerns of patients with stage 5 CKD on dialysis over time and towards death, to explore their illness and symptom experience, including the experience of change over time, and to suggest ways in which quality of their care may be therefore improved.
References
1. Murtagh FE, Marsh JE, Donohoe P, Ekbal NJ, Sheerin NS, Harris FE: Dialysis or not? A comparative survival study of patients over 75 years with chronic kidney disease stage 5. Nephrol Dial Transplant 22: 1955–1962, 2007
2. Tamura MJ, Covinsky KE, Chertow GM, Yaffe K, Landefeld CS, McCulloch CE: Functional status of elderly adults before and after initiation of dialysis. N Engl J Med 361: 1539–1547, 2009
3. Jassal SV, Watson D: Dialysis in late life: benefit or burden. Clin J Am Soc Nephrol 4: 2008–2012, 2009
4. Jassal SV, Chiu E, Hladunewich M: Loss of independence in patients starting dialysis at 80 years of age or older. N Engl J Med 361: 1612–1613, 2009
5. Foote C, Kotwal S, Gallagher M. et al. Survival outcomes of supportive care versus dialysis therapies for elderly patients with end-stage kidney disease: a systematic review and meta-analysis. Nephrology (Carlton) 2016; 21: 241–253
6. Kane PM, Vinen K, Murtagh FE. Palliative care for advanced renal disease: a summary of the evidence and future direction. Palliat Med. 2013;27:817–21.
7. Murtagh FE, Addington-Hall J, Higginson IJ. The prevalence of symptoms in end-stage renal disease: a systematic review. Adv Chronic Kidney Dis. 2007a;14:82–9.
Funding
Tuition fees and bursary.
Benefits
The successful candidate will receive comprehensive research training including technical, personal and professional skills.
All researchers at Coventry University (from PhD to Professor) are part of the Doctoral College and Centre for Research Capability and Development, which provides support with high-quality training and career development activities.
Candidate specification
- A bachelor’s (honours) degree in a relevant discipline/subject area with a minimum classification of 2:1 and a minimum mark of 60% in the project element (or equivalent), or an equivalent award from an overseas institution.
- the potential to engage in innovative research and to complete the PhD within 3.5 years
- An adequate proficiency in English must be demonstrated by applicants whose first language is not English. The general requirement is a minimum overall IELTS Academic score of 7.0 with a minimum of 6.5 in each of the four sections, or the TOEFL iBT test with a minimum overall score of 95 with a minimum of 21 in each of the four sections.
For further details please visit: https://www.coventry.ac.uk/research/research-opportunities/research-students/making-an-application/research-entry-criteria/
Additional requirements
Background and training in health-related field or the social sciences. Applicants with demonstrated academic and/or professional experience in the field of nephrology and / or palliative care are also considered. A keen interest in both hands-on research activities and data analysis as well as problem solving skills and creativity is essential. Knowledge and experience of research is very desirable for example in systematic reviews, quantitative, qualitative and mixed methods research.
How to apply
To find out more about the project please contact Dr Emma Murphy, Associate Professor in Nephrology Nursing.
All applications require full supporting documentation, and a covering letter – plus up-to 2000-word supporting statement showing how your applicant’s expertise and interests are relevant to the project.
Apply to Coventry University
